Preheat the oven to 375°F (190°C). Grease a 9x13-inch baking dish and set aside.
Bring a large pot of salted water to a boil. Add the elbow macaroni and cook until just al dente according to package directions, about 7–8 minutes. Drain and set aside.
In a large saucepan over medium heat, melt the butter. Whisk in the flour and cook for 1–2 minutes until the mixture is bubbly and lightly golden.
Slowly whisk in the milk and heavy cream, stirring constantly until smooth. Cook until the sauce thickens and coats the back of a spoon, about 5 minutes.
Remove the sauce from heat and stir in the cream cheese until melted. Add the shredded cheddar and Gruyere a handful at a time, stirring until fully melted and smooth.
Stir in the Dijon mustard, Old Bay seasoning, paprika, salt, pepper, and lemon juice. Taste and adjust seasoning as needed.
Fold the drained pasta, shrimp, and crab meat into the cheese sauce until evenly combined.
Pour the mixture into the prepared baking dish. Toss the panko breadcrumbs with a tablespoon of melted butter and sprinkle evenly over the top.
Bake uncovered for 18–22 minutes until the top is golden and the filling is bubbly. If desired, broil for 1–2 minutes to brown the topping, watching carefully.
Remove from the oven and let rest 5 minutes. Garnish with chopped parsley and serve warm.
Notes
Make ahead: assemble and refrigerate up to 24 hours before baking. Add extra lemon juice or hot sauce to taste.